Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
TriVox Health is an online system designed to make it easy for healthcare providers to monitor patients' disease symptoms and functioning over time and in between in-person visits (http://www.youtube.com/watch?v=VR1vcbx0Ef4). Using combined quality improvement and randomized clinical trial methods, we will evaluate the impact of TriVox on the health outcomes, patient/family experience of care, and healthcare utilization for children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD), asthma, autism, depression, and epilepsy.
TriVox Health is a web-based patient management and monitoring system designed to track patients' disease symptoms and response to therapy over time. TriVox Health enables clinics to use electronic surveys to gather data remotely from multiple responders, including patients, parents/guardians, school personnel and ancillary providers, and view the responses in a timely manner via graphical, tabular, and narrative summary formats.
This quality improvement (QI) initiative will implement TriVox as the standard of care for all patients who receive care for ADHD, asthma, autism, depression, and epilepsy within seven ambulatory specialties at Boston Children's Hospital. Patients and families will use TriVox to report on patient health status and will complete clinically-reTriVoxlevant questionnaires at routine intervals. Providers will use the information collected through TriVox to inform their clinical care of the patient/family.
To evaluate the effectiveness of TriVox, we will conduct a 24-month phased, cluster randomized controlled trial (RCT) where we randomize providers to "active" vs. "delayed-start" to TriVox use, with patients clustered by provider (within specialties) for analytic purposes. Delayed-start providers will crossover to active TriVox use after 12 months. Patients/families will complete additional surveys in order to assess the system's actual or potential effects on patient/family-provider interactions, healthcare utilization and costs.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TriVox Active | Experimental | Provider using TriVox for clinical care |
|
| TriVox Delayed-start | No Intervention | Providers not using TriVox for clinical care |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TriVox for clinical care | Other | Use TriVox disease modules to manage patients |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in caregiver-rated disease-specific symptoms | Caregiver-reported ratings on disease-specific symptom rating scale. For example, Vanderbilt ADHD Parent Rating Scale for ADHD; Asthma Control Test for asthma | Baseline to 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Number of patients with "red flag" alerts | Number of patients whose responses to clinical questionnaires trigger a "red flag" alert in ICISS | 1 month |
| Change in caregiver-rated global functioning |
| Measure | Description | Time Frame |
|---|---|---|
| Healthcare utilization | inpatient and ambulatory visits within healthcare system directly related to patient's medical or mental health condition | 12 months |
| Direct out of pocket expenditures | Out of pocket expenditures directly related to care for child's medical or mental health condition, e.g. co-pays, prescription costs |
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Eugenia Chan, MD, MPH | Boston Children's Hospital | Principal Investigator |
| Eric Fleegler, MD, MPH | Boston Children's Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Boston Children's Hospital | Boston | Massachusetts | 02115 | United States |
Not provided
| Label | URL |
|---|---|
| ICISS: Collaborating Online to Improve Children's Health Care | View source |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| ID | Term |
|---|---|
| D001289 | Attention Deficit Disorder with Hyperactivity |
| D001249 | Asthma |
| D000067877 | Autism Spectrum Disorder |
| D003863 | Depression |
| D004827 | Epilepsy |
| D002908 | Chronic Disease |
| ID | Term |
|---|---|
| D019958 | Attention Deficit and Disruptive Behavior Disorders |
| D065886 | Neurodevelopmental Disorders |
| D001523 | Mental Disorders |
| D001982 | Bronchial Diseases |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Caregiver ratings on modified Clinical Global Assessment Scale
| Baseline to 12 months |
| Experience of care | Participant ratings on Post-Visit Experience of Care Survey | Baseline and after every ambulatory visit for up to 84 months |
| 12 months |
| D012140 | Respiratory Tract Diseases |
| D008173 | Lung Diseases, Obstructive |
| D008171 | Lung Diseases |
| D012130 | Respiratory Hypersensitivity |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |
| D002659 | Child Development Disorders, Pervasive |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |